Why is There so Much Controversy Regarding the Population Health Impact of the Great Recession? Reflections on Three Case Studies

Abstract

In the aftermath of the Great Recession, public health scholars have grown increasingly interested in studying the health consequences of macroeconomic change. Reflecting existing debates on the nature of this relationship, research on the effects of the recent economic crisis has sparked considerable controversy. On the one hand there is evidence to support the notion that macroeconomic downturns are associated with positive health outcomes. On the other hand, a growing number of studies warn that the current economic crisis can be expected to pose serious problems for the public's health. This article contributes to this debate through a review of recent evidence from three case studies: Iceland, Spain, and Greece. It shows that the economic crisis has negatively impacted some population health indicators (e.g., mental health) in all three countries, but especially in Greece. Available evidence defies deterministic conclusions, including increasingly "conventional" claims about economic downturns improving life expectancy and reducing mortality. While our results echo previous research in finding that the relationship between economic crises and population health is complex, they also indicate that this complexity is not arbitrary. On the contrary, changing social and political contexts provide meaningful, if partial, explanations for the perplexing nature of recent empirical findings.

Medium-term impact of the economic crisis on mortality, health-related behaviours and access to healthcare in Greece

“…Despite earlier reports of increasing homicides9, and all-cause mortality11, our comparison with pre-crisis trends revealed no evidence of changing trends during the crisis, which is in line with mortality trends observed during recessions in the past15. Close monitoring is required in order to explore whether the increase observed in 2015 signifies a dramatic change in the course of the Greek crisis or it was a statistical anomaly without further implications.…”

“…One issue that has already been highlighted as a negative consequence of the economic crisis is the increase in suicides and suicide attempts1516. Our analysis showed that the standardised mortality from suicides increased rapidly after 2009.…”

“…However, most of these studies included data only from the first two years of the crisis and only report short-term effects. As a result, there is still a lot of uncertainty regarding the health effects of the crisis in Greece, which reflects a controversial evidence base on the short- and long-term impact of economic downturns on health in general15.…”

Impact of the financial crisis on COPD burden: Greece as a case study

“…In the Greek population, early reports have suggested a negative effect of financial crisis on public health [3, [9][10][11][12], and remarkably on respiratory health [1, 9,10,[13][14][15]. The impact of the Greek downturn on respiratory health was apparent even though most studies used data covering only the first years of the crisis and reported its short-term effects [16]. This article summarises the overall impact of the financial crisis on chronic obstructive pulmonary disease (COPD) burden throughout the period of economic downturn, analysing the case study of Greece.…”

The Great Recession and suicide

“…One key point of much of this work is that the institutional context in which economic disruptions occur may modify any impact on suicide rates [48]. For example, it has been argued that the impact of recessions is weaker or not evident in places with stronger labor market protections, such as Scandinavia [7,49].…”